RAAS及血清TGF-β1水平对糖尿病肾病伴高血压患者肾功能损伤的影响  

Effect of RAAS and Serum TGF-β1 Level on Renal Function Injury in Diabetic Nephropathy Patients with Hypertension

作　　者：沈丽莎[1,2] 李锦伟[3] 黄珊[2] 季黎明[2] 石勇铨[1] 

机构地区：[1]第二军医大学附属长征医院/上海长征医院内分泌科,上海200003 [2]上海交通大学医学院附属同仁医院/上海市同仁医院内分泌科,上海200050 [3]上海交通大学医学院附属同仁医院/上海市同仁医院老年科,上海200050

出　　处：《现代生物医学进展》2016年第32期6360-6363,共4页Progress in Modern Biomedicine

基　　金：2014年度上海市同仁医院院级科研基金项目(TR201410)

摘　　要：目的:探究肾素-血管紧张素-醛固酮系统(RAAS)与转化生长因子-β1(TGF-β1)对糖尿病肾病(DN)合并高血压患者肾功能损伤的影响,为临床治疗提供依据。方法:选择2014年6月2015年6月期间我院收治的DN患者76例为研究对象,根据是否合并高血压将其分为DN合并高血压组(39例)和单纯DN组(37例),另选择我院健康体检者40例为对照组,检测并比较各组间醛固酮(ALD)、肾素、血管紧张素(ATII)、血肌酐(Scr)、肾小球率过滤估计值(e GFR)、尿素氮(BUN)及尿N-乙酰-β-D氨基葡萄糖苷酶(NAG)水平。结果:DN合并高血压组与单纯DN组患者肾素、ATII、Scr、BUN、TGF-β1及NAG水平显著高于对照组,DN合并高血压组肾素、ATII、Scr、BUN及TGF-β1水平均显著高于单纯DN组,差异均具有统计学意(P<0.05);DN合并高血压组患者e GFR水平显著低于对照组与单纯DN组,且单纯DN组显著低于于对照组,差异均具有统计学意(P<0.05);Wilcoxon秩和检验显示,DN合并高血压组肾素、ATII、Scr、BUN、TGF-β1及NAG水平随DN分级增加而增加,e GFR水平随DN分级的增加而降低,差异均有统计学意义(P<0.05);DN合并高血压组患者肾素、ATII及TGF-β1水平与e GFR水平呈现负相关关系(r=-0.523,-0.601,-0.401;P<0.05),与Scr(r=0.338,0.414,0.141,P<0.05)及NAG(r=0.341,0.413,0.411;P<0.05)呈现正相关关系。结论:DN伴高血压患者机体RAAS及血清TGF-β1水平均显著升高,且患者DN病情越重,其水平越高。Objective： To study the effect of renin angiotensin aldosterone system（RAAS）and serum transforming growth factor-β1（TGF-β1）level on renal injury function in diabetic nephropathy（DN） patients with hypertension, so as to provide basis for clinical treatment. Methods： Selected 76 cases of patients with DN who were treated in our hospital from June 2014 to June 2015 as the objects,and were divided into DN with hypertension group（n=39） and simple DN group（n=37） according to whether or not combined with hypertension, than selected 40 cases of healthy physical examination people in our hospita as the control groupl, detected and compared the levels of aldosterone（ALD）, renin, angiotensin（ATII）, serum creatinine（Scr）, estimated glomerular filtration rate（e GFR）,urea nitrogen（BUN） and N-acetyl-β-D-glucosaminidase（NAG）. Results： The levels of renin, ATII, Scr, BUN, TGF-β1 and NAG in DN with hypertension group and simple DN group were higher than that of control group, the levels of renin, ATII, Scr, BUN, TGF-β1 and NAG in DN with hypertension group were higher than that of simple DN group, the differences were statistically significant（P〈0.05）; The levels of e GFR in DN with hypertension group was lower than the control group and simple DN group, and the simple DN group was lower than that of the control group, the differences were statistically significant（P〈0.05）; Wilcoxon rank sum test showed that the levels of renin, ATII, Scr, BUN, TGF-β1 and NAG in DN with hypertension group were increased alone with the increase of DN grade, the level of e GFR was decreased alone with the increase of DN grade, the differences were statistically significant（P〈0.05）; The levels of renin, ATII and TGF-β1 were negatively correlated with the level of e GFR of patients in DN with hypertension in group（r=-0.523,-0.601,-0.401; P〈0.05）, and were positively correlated in Scr（r=0.338, 0.414, 0.141, P〈0.05） and NAG（r=0.341, 0.413, 0.411; P〈0.05）.Conclus

关 键 词：RAAS TGF-Β1 糖尿病肾病 高血压 肾功能 

分 类 号：R587.2[医药卫生—内分泌]